Q. When is it time for a teenager to make the transition from a pediatrician to a "grown-up doctor." Is there a certain age when this should happen? And what can I do to prepare my daughter for the switch?
A. Great question. In fact, this question highlights one of the paradoxical and interesting things about pediatrics: pediatricians work to help families assure that children grow up healthy, well-adjusted and successful so that they can reach their ripe old age of 20-something and never see a pediatrician again.
Believe it or not, there is a lot of thought and research about the idea of health-care transition. Particularly important for children with chronic illnesses, families and health-care providers must help patients go from children whose parents make all decisions for them to adolescents who play a role in helping to make health-care decisions to young adults who seek out parents or input from others only when they need it. These young adults must understand their health and understand how to access health care.
The official age at which the American Academy of Pediatrics suggests these transitions begin to occur is age 21, and pediatricians are fully trained to take care of young adults into their 20s. However, many pediatricians think that this is a difficult and awkward time to change physicians and that the transition age should be later, more like the mid-20s. However, many pediatricians see relatively few teens and notice that many of their patients begin transitioning to family physicians who care for other members of their family. So again, there is no absolute answer to a relatively simple question that you asked.
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The bottom line is there is not a single age at which it becomes time to transition to other providers. A transition ideally will be planned well ahead of time with input from your pediatrician to help you identify and work with a new clinician. However, it can also happen at the time of a move, new medical diagnosis, change of insurance, or other transition. You can help your young adult child to be ready for this transition by allowing her to schedule appointments for herself while you can still help her, make sure she understands any medical diagnoses she has, and help empower her to talk with her doctor about questions that come up.
Getting older is inevitable, and a transition from a pediatrician to a different clinician is something that can usually can be successful if planned.